My 12 year old chubby cat has suddenly lost her appetite and is sleeping constantly

Hi;

Please tell me they checked a blood glucose when she recently went in. That would be my first thing on the list with her. If they didn't you really should have that checked.

This last vet visit she did not have any tests done at all. 

Last December is when she had a basic blood test done.

I do still think I should take her in for the more extensive blood panel so I can get all the info on her inner works Make sure there is nothing going unnoticed/untreated.

By drinking more water do you mean hanging out at the water bowl with a wet chin all the time? Have you noticed a wet chin at all? Or do you mean she may drink a little more water like you see her at the water bowl briefly twice a day as opposed to once?

Is anyone in your family diabetic? Do you have  a glucometer at home? Do you have any urine glucose dip sticks at home? Do you notice any strange odor to the urine?

I read your post from 6 months ago. It looks like there was an infection going on somewhere at that time, thus the elevated white blood cells. the Eosinophil count being elevated back then as you know could have been due to an allergic response to something, a parasitic infection, heartworms, and a few other things. The allergic response doesn't have to be food it could be inhaled allergies that manifest through itching. It could also be an IBD thing but without other symptoms I wouldn't suspect it. 

I honestly don't see how pancreatitis can be suspected since the pancreas is hard enough to visualize during ultrasound let alone through palpation. I don't know that I would treat for something that was not actually diagnosed. But that is just me. Who knows, maybe there is something that is blaring pancreatitis to this Vet and she is going on her gut instinct. I have know way of knowing. So use your best judgment.

But, I would always consider diabetes in a middle aged plump cat that has increased water intake especially in light of recent weight loss.

The wbc elevation is due to the eos being high.

She is clear of fleas and parasites. Despite my already knowing this, I did go ahead and have a fecal float done back then to rule out all possibility.

He told me it points to likely a food allergy.

I can see why too, she has also had too much fish flavored canned, and crappy kind too, I used to give her friskies, as I have had a hell of a time getting her to eat other brands.

Friskies is now completely out, although she is still getting fancy feast but majority is chicken or turkey.

I am at a total loss of what to feed her now.

Watching her weight, allergies, and easy on her pancreas has left me stopped in my tracks.

I am clueless.

As for Krissy and how she is doing, appetite is back in full swing now, she is consuming much more water still then her norm.

No doubt about that.

Her bloodwork done Dec 31st indicates no signs what-so-ever of diabetes, kidney, liver, nothing out of the norm.

i am glad she is feeling better.

I feed my cats fancy feast. Some of it isn't all that bad. The classic variety is the healthiest. But if you are dealing with a food allergy then you need to figure out a novel protein and start there with no other food. You stick with it for 3 months and hope there is improvement. If not you find another protein source and repeat. It is exhausting and frustrating dealing with food allergy and sometimes a trigger can never be found.

Yes it is always the classics.

However, I know for the allergy part it must be completely switched to one type of protein she has not had to settle the allergic reaction down completely, then start again.

So how am I to do this while still considering her weight issue as well as something that is easy for her pancreas to handle?

As I said, I haven't got a single clue where to go from here.

I also don't know anything about food and pancreas, how to baby it basically.

This is a really good website for pancreatitis, diet, etc.

http://www.ibdkitties.net/pancreatitis.html

I would start there. If you look around the site there is a lot of good information on there.

Be careful with any kind of switch or change in diet with any cat but especially a cat that so recently didn't want to eat. You don't want her to start vomiting and get food aversion going and etc.

This is a really good site. While I don't agree with feeding raw foods myself. I do still think the sites information is good. I have seen some cats that were not doing well before do great on the raw diet so I am not going to argue about it because it does have some benefits I think but in general I have see salmonella cases before and don't ever want to see them again. So, I cannot say I agree with it.

It is very hard to figure out what it is causing the allergic response in a cat when it comes to a food allergy. You have to figure that you need about 3 months to figure out if the novel protein source is going to be the one to work or not.

Thank you.

I'm still stuck with what an appropriate diet should be for Krissy........

I don't want to feed raw.

catwoman707 said:

 
Thank you.

I'm still stuck with what an appropriate diet should be for Krissy........

I don't want to feed raw.

Click to expand...

Did you say she was a picky cat? That makes it much more difficult.

Sebastian is a good eater (when he's feeling good), but has expensive taste. He turns his nose up at the cheaper foods and likes the ones that are $2+ a can. Here's his menu (except I've had to eliminate Nature's Variety Instinct Pork canned food because it made him itchy): http://www.thecatsite.com/t/274500/best-rotation-to-prevent-food-allergies/60#post_3572252

Yes, she is picky, and not for the better stuff, she won't eat most of it, I have sure tried.

Also very hard to find a canned and a dry..........ugh.

So in looking at your link, I see alot of raw diet. Does it have to be raw or can it be cooked?

Also, would you say that starting off with rotating will settle her allergic response down or do I need to get that straight first?

She has itchy skin and slight eye/nose signs. Never been sick with a uri ever so it's not that, started the same time as her skin itching and vet said that's what that is too.

This just developed 2 years ago and she is 12. Fine with food until then......

catwoman707 said:

 
Yes, she is picky, and not for the better stuff, she won't eat most of it, I have sure tried.

Also very hard to find a canned and a dry..........ugh.

So in looking at your link, I see alot of raw diet. Does it have to be raw or can it be cooked?

Also, would you say that starting off with rotating will settle her allergic response down or do I need to get that straight first?

She has itchy skin and slight eye/nose signs. Never been sick with a uri ever so it's not that, started the same time as her skin itching and vet said that's what that is too.

This just developed 2 years ago and she is 12. Fine with food until then......

Click to expand...

There's no raw. The menu very specifically says canned and home-cooked. The home-cooked is supplemented with a product called Balance It. You can read more about home-cooked diets here: http://www.thecatsite.com/t/264153/home-cooked-cat-food-resources

I developed a rotation for Sebastian because he was on a rabbit-only diet for five months and I feared he would become allergic to rabbit. As we ventured out into other proteins, I accidentally discovered that he is severely allergic to guar gum, so the menu I linked to is a guar gum free diet. Our options are limited because guar gum is in almost everything. The proteins he eats are also based on the recommendation by a vet trained in Chinese medicine. Sebastian's menu is just an idea.

Boo, on the other hand, has/had allergies similar to Krissy. Last fall I started feeding him Fancy Feast, Sheba, Friskies, etc. to help him put on weight. After few months, he started tearing his skin up, patches of hair were missing from his ears, and he had a recurring ear infection. I took him off all those foods and eliminated chicken, beef, and fish from his diet. He was not happy with me. He's very picky like Krissy and also very stubborn, but I kept it up for three months with a very small rotation of canned foods without chicken, beef or fish. The ear infection cleared up and he became less itchy. He still scratches his neck every once in awhile (he's flea free), so I don't know. Just last week I began to reintroduce chicken. I honestly think it was the by-products and additives in the cheaper foods that set him off. But I guess we'll see if he starts reacting to the chicken. If he doesn't react to it, then I'll reintroduce beef or fish next. The reason I eliminated chicken, beef, and fish is because that is mainly what is in most cat foods, especially the cheaper ones. I looked. There is not one flavor of Fancy Feast, Sheba or Friskies without "meat by-products."

Some cats just don't take to novel protein diets at all. If Krissy won't eat lamb, venison, rabbit, etc., then you could try giving her limited ingredient duck and/or turkey foods. However, some cats who have an allergy to chicken can also be sensitive to other "winged creatures". This is why a true novel protein is typically recommended.

@Quiet  and @GoHolistic  and anyone else, I would love some input regarding Krissy's blood results and urinalysis.

Sorry, having trouble with new computer but am looking some things up right now. How is she feeling?

Hi,

Well. what did the vet say? How is she acting? Still drinking extra water? Appetite?

I am of course not a vet but I would guess at early renal disease. Reason for that is the dilute specific gravity in the urine. That should be higher in a normal cat. Cats concentrate their urine very well if they are healthy. I wouldn't be concerned about the trace of blood in the urine because it was a cysto, so most likely the blood is from the needle stick. I would get the ph within normal range asap. That can be done with a veterinary acidifying diet such as Royal Canin S/O, or any other number of veterinary diets out there. Although I hate to ever recommend them since I think that the food itself is crap but it does seem to do what it is supposed to with the urine ph. Maybe Go Holistic would have a better recommendation for an acidifying diet that won't cause any problems to an already sensitive GI.

The blood work itself has a high white blood count which as you know is inflammation, infection. The monocytes being elevated can indicate the inflammation being chronic. The neutrophils being high also signify inflammation/infection.

Triglyceride elevation can be caused by diabetes, pancreatitis, liver disease such as hepatic lipidosis

Amylase being high is not considered significant unless it is at least twice what it should be. (in cats)

The below link has a ton of information on it. If you can't access it let me know and I will copy and paste. But look all around that web site and you should be able to gain some better insight into what is going on.

I think maybe early kidney disease that isn't bad enough to show up on the kidney values on the blood tests. But I am just guessing here. I am curious if the vet you use spins down their blood samples before they send them into the lab.

If she was my cat I would try to find an internal medicine vet to do an ultrasound of her abdomen. That is the only way to get a good idea of what is going on with her kidneys, liver, pancreas, lymph nodes and they can even see if there is any thickening to the intestines. But if you do an ultrasound have it done by a vet that does 100 a week, not a vet that mostly uses their ultrasound for cystos and maybe only does 1 or 2 a week since ultrasound is very subjective and only as good as the vet doing them.

Ultrasounds are not cheap though. So if I couldn't do that I would maybe ask the vet about doing some sub q fluids at home. And make sure she is eating well. I would not worry as much about the food allergy right now and make sure she eats enough not to go into hepatic lipidosis, as I have seen cats get it from just a great reduction in food.

Here is the link:http://eclinpath.com/

Of course, I had a long reply, but when I went to post it, it signed me out and I lost the message (draft never saved).    I will try to remember what I wrote.

I am not a vet, either, and have all the same questions as @Quiet. What did the vet say about this? How is Krissy?

I would personally be concerned about the elevated WBC / neutrophils, which could indicate moderate inflammation and/or infection as Quiet already mentioned. I say "moderate" only relative to Sebastian's severe episode of pancreatitis last year. His WPC count was 30.43 and neutrophils were 25.97 (using the same ranges you have). He had to be hospitalized. The high urine pH is also concerning since that can lead to other urinary issues.

According to Idexx, monocytes are inflammatory cells associated with the repair of tissue injury. Amylase increases may be seen with pancreatitis, kidney disease, and/or gastrointestinal disease. (Sebastian's amylase on standard blood work was never elevated, however.) Triglyceride increases may be seen in patient’s with pancreatitis, diabetes, Cushing’s disease, or hypothyroidism.

I think I provided these resources before, but will post them again for your reference.

From Idexx: Understanding Your Pet's Diagnostic Testing

http://www.idexx.com/pubwebresource...ient-education/understand-diagnostic-test.pdf

From Antech: Blood Analysis & Testing

http://www.antechdiagnostics.com/Uploads/Public/Documents/Blood Analysis and Testing Guide.pdf

From WSU: What Do Those Lab Tests Mean?

http://www.vetmed.wsu.edu/cliented/lab.aspx

Thank you!

Krissy is doing good, she seems to be herself again after her traumatic experience at the vet......I didn't mention that part. Ugh...hurts my heart and I feel as traumatized as she must just knowing what she went through.

Since I have a rescue and deal with so many things, have lots of meds, Krissy missed out on going to the vet since she was 1 1/2 years old. Ten+ years later was the vet visit last December.

This last time with the blood/urine tests, she really put up a fight, after 10 minutes they said they wanted to medicate her to calm her down to get the blood. I made an unhappy face and another tech said she would go help.

4 including the vet it took, and a muzzle on her. I could hear her screaming.......she was terrified. How horrible to think if she has an illness that requires bloodwork repeatedly, she will have to go through that again...

So as I said, back to her norm except for the water consumption, and her sometimes sleeping in oddball spots. Right in the middle of the hallway, or in the living room but like a random spot, facing nothing, or the wall rather than the front door, or something.

I don't remember if her former blood test results are posted here from last Dec. but found it interesting how some things have changed compared to now, 8 months later.

Her eos back then were quite high, after ruling out fleas/parasites it seemed to be from a food allergy, and despite that they are normal now, her itchy skin has not changed. Now her Neutros and Monos are high.

The vet didn't give me the results, I was given a copy but haven't discussed them with the vet, until Tuesday..........hate it.

Glad you mentioned about the trace blood, I was wondering about that one.

Her spec gravity looks normal.

What I see is low Na/K ratio

High triglycerides

High amylase

High neutrophils

High monocytes.

High PH

Together I don't know what this means. I can tell it can point to kidney or pancreatitis, or both?

The high wbc looks to me like from inflammation. Pancreas maybe??

Hi

It really sickens me when I hear of that kind of treatment of a cat at a vet hospital. That is why I have so much trouble when I have to work with other people around cats. Nobody should ever try to over power a cat, ever. Nothing good comes from that. When I was working I would get blood from cats that nobody else could because I would do it myself in about 3 seconds, before the cat really thought about it. And I would do it myself. You don't ever need more people with a cat, you either need quiet in a cardboard box or another day but never more people. I am so sorry for you and your cat and what you both went through and the guilt and sick I am sure you feel from bringing her there. I feel sick for ever suggesting that you take her to a vet. Cats are not small dogs and people just don't seem to get that. Cats have the unique behavior of a predator/prey species and until people at vet hospitals get that they will never understand.



So this is my take on it. Some of this you can reference to books and some of it isn't in the medical books because it is what I have learned on my own. So take from that what you will. I am not a vet and don't write books. This is just what I have figured out and it is all in "Quiet's World" if you know what I mean. I don't expect you to listen to what I am saying or override your vets decisions etc. I am just totally covering my out of shape glutes here. All disclaimers given noted and logged, this is what I think:



OK so..... obviously the elevated WBC is infection somewhere. The Monocytes are telling us it has been going on a while. The Amylase I would disregard because it isn't double the normal value and I have always been told in cats that you don't even consider it until it is double. Te pancreatic tests done in the general health profiles on cats are not very accurate. For dogs they are fine, for cats not so much. With cats if you are trying to find out if it is pancreatitis or not you need ultrasound and a specialized test:

This will be easier, below is  a quote from a seminar in 2011 on pancreatitis in cats and how the amylase and lipase isn't relevant and also about the PLI testing:

Had some problems with the above post. Anyway, If it was me I would make sure that she is on antibiotics. Don't switch, stick with one. Make sure she is eating enough. Might want to try a trial of babyfood in either chicken lamb or beef and only feed that for a week and see if there is improvement. Because she might not be allergic to a protein source it could be corn or rice or anything else if it is an allergy. I would give her a dose of revolution if it was me just because. I wouldn't vaccinate for now, if ever. I would check hydration and temp daily and if dehydrated give 50cc LRS sub q. I would look into a product called pancreazym. I would also treat her as an early stage renal kitty by keeping her hydrated. I would even consider doing 50cc LRS daily, provided it was all absorbed, and see if she felt better in two or thee days.

The urine concentration although considered normal by some I consider dilute if it isn't near high off scale. Cats are animals that concentrate their urine. Dilute urine in a cat not on fluid therapy is a cause for concern.

OK all my stuff for now. And like I said this is just what I would do but not what I am recommending you do. Have to run.

Thank you so much.

I have been digging around alot and here is what I got from some info.

The neutrophils being so high, the first thing a couple sites say is to rule out stress, this change occurs in just minutes and can not be accurately read as high.

That makes TOTAL sense, something HAD to be off because it was so over the top traumatic for her. I still cringe when I think of what she went through. I can't imagine how terrifying that must have been......

Now it does say that the high triglyceride is due to her blood test being a non fasted test.

The slightly dilute urine can be explained by her increased water intake, she drinks alot.

The Na/K ratio being low can be due to her vomiting about once a day, she had vomited the day before the test. (??) Not sure there.

I also felt able to go with taking one or two things that are abnormal numbers and looking at those causes, and ruled out (in my mind at least) kidney disease/failure. Her other numbers just don't correlate with that.

She could have mild pancreatitis, or cancer of some sort. High PH, I don't know why that is either.

The dreaded cancer I can't rule out here but of course scares me more than anything else. Very non descript info of type, etc.

I hate waiting for Tuesday, ugh.....